title: Transmission of tuberculosis in resource-limited settings.
abstract: Unrecognized transmission is a major contributor to ongoing TB epidemics in high-burden, resource-constrained settings. Limitations in diagnosis, treatment, and infection control in health-care and community settings allow for continued transmission of drug-sensitive and drug-resistant TB, particularly in regions of high HIV prevalence. Health-care facilities are common sites of TB transmission. Improved implementation of infection control practices appropriate for the local setting and in combination, has been associated with reduced transmission. Community settings account for the majority of TB transmission and deserve increased focus. Strengthening and intensifying existing high-yield strategies, including household contact tracing, can reduce onward TB transmission. Recent studies documenting high transmission risk community sites and strategies for community-based intensive case finding hold promise for feasible, effective transmission reduction. Infection control in community settings has been neglected and requires urgent attention. Developing and implementing improved strategies for decreasing transmission to children, within prisons and of drug-resistant TB are needed.
authors.affiliation: Boston University School of Medicine, 72 E. Concord Street, Boston, MA 02118, USA. tkompala@gmail.com
authors.forename: Tejaswi
authors.initials: T
authors.lastname: Kompala
authors.forename: Sheela V
authors.initials: SV
authors.lastname: Shenoi
authors.forename: Gerald
authors.initials: G
authors.lastname: Friedland
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000517:prevention & control; D003428:Cross Infection / Q000517:prevention & control; D006268:Health Facilities / Q000592:standards; D006801:Humans; D013019:South Africa; D014376:Tuberculosis / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission*; D018088:Tuberculosis, Multidrug-Resistant / Q000517:prevention & control
chemical_list: D000995:Antitubercular Agents